Whether the children were in day care made no difference in immunization
rates, say Carol A. Stanwyck, Ph.D., and two colleagues from the Centers
for Disease Control and Prevention.
Their work appears in the American Journal of Preventive
Medicine.
“School entry legislation in the United States has been a critical
factor in keeping coverage rates high among kindergartners and first-graders,” Stanwyck
says. “Immunization regulations related to childcare facilities
have not had a similar impact.”
Current school laws have resulted in vaccination rates of more than 95
percent among those older children. But similar laws or regulations in
all states and the District of Columbia applying to childcare settings
have not proven so successful.
For children 19 months to 35 months old, the rates were only 76 percent
for those in childcare and 73 percent for those never in childcare. The
difference between those in or not of childcare was statistically insignificant,
Stanwyck says.
Of the preschoolers who were not up to date on vaccinations, more than
90 percent were missing more than one dose.
Vaccines in the survey included diphtheria, tetanus, pertussis, polio,
measles, hepatitis B and Haemophilus influenzae type b.
Unlike the laws governing school entry, regulations for child care immunization
lack standard assessment and enforcement policies, says Stanwyck.
“For example, some monitor only licensed centers, while others include
family childcare programs as well,” she says. Some states record
the status of all children in day care, while others check only those
age 2 or older.
Vaccine-preventable diseases are on the decline in the United States but
outbreaks still occur, Stanwyck says. Preventing future outbreaks depends
on maintaining proper levels of immunization.
“Revised strategies and more effort are needed to
improve coverage of children who attend and do not attend childcare programs.”
